# 1 -Understanding Recent Trends in Mortality and Morbidity

> **NIH NIH P01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2020 · $163,068

## Abstract

PROJECT SUMMARY/ABSTRACT
Project 1 – Understanding Recent Trends in Mortality and Morbidity
The goal of this project is to understand the deterioration in health among middle-aged American men and
women, especially among white non-Hispanics – only recently brought to light. After three decades of decline,
all-cause mortality rates for white non-Hispanics aged 45–54 have been on the rise since 1998. The increase
has been driven by drug and alcohol poisonings, suicides, and cirrhosis and alcoholic liver disease. If white
non-Hispanic mortality rates had continued to decline at 1.8 percent a year after 1998 – the average rate of
decline for whites in the previous two decades – about 500,000 deaths would have been avoided through
2013, a number comparable to cumulative AIDS deaths in the U.S. There has been no corresponding change
in the rate of mortality decline for non-Hispanic blacks or for Hispanics. In the same age group, morbidity
among white non-Hispanics has increased for a range of measures, including self-reported physical and
mental health, chronic pain, ability to conduct activities of daily living, including work, self-reports of heavy
drinking, and clinically measured liver function. In contrast to the midlife group, mortality and morbidity have
continued to improve for those aged 65 and above.
The project will drill down into these overall statistics, disaggregating by location, by age, by sex, by
occupational and educational groups, and by race and ethnicity, as well as by making comparisons with other
wealthy countries. It will also attempt to understand the causes behind the decline in midlife health. There are
two broad Specific Aims: (1) to build a public use database for the U.S. and for other rich countries that will be
rich enough to document, for the U.S., the geographical distribution of midlife deaths and to link mortality and
morbidity patterns, across space and time, to patterns of income, poverty, inequality, employment,
unemployment, education and occupation and, internationally, to study the differences and similarities in
mortality and morbidity patterns between the U.S. and other rich countries; and (2) to use the spatial and
temporal ordering of those data to consider a range of hypotheses and possible determining factors, including
(i) diminishing economic opportunity, especially for those with only a high school degree or less education, (ii)
increases in pain and morbidity, before and after the marked increase in opioid availability, (iii) changes in
occupational structure on reports of pain and other morbidity, and (iv) education itself, in conditioning mortality
and morbidity independent of occupation and income. We will test whether hypotheses on economic
prosperity, pain and other morbidity, increased availability of opioids, occupation, and education help to explain
the differences between the US and other rich countries, and differences between racial and ethnic groups
within the U.S.

## Key facts

- **NIH application ID:** 9990663
- **Project number:** 5P01AG005842-32
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** ANNE CASE
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $163,068
- **Award type:** 5
- **Project period:** — → —

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990663

## Citation

> US National Institutes of Health, RePORTER application 9990663, 1 -Understanding Recent Trends in Mortality and Morbidity (5P01AG005842-32). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9990663. Licensed CC0.

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